Matthew C Cannon, DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

7854 Issued in IA

Practice address

3520 Utica Ridge Road
Bettendorf, IA 52722

Phone

(563) 359-9165

Fax

(563) 359-1824

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dentistry Unlimited 1 PLC

  • General Practice Dentistry
  • Bettendorf, IA
  • NPI 1689898603
  NPD (past)
• Kimball & Beecher Group LLC

  • General Practice Dentistry
  • Bettendorf, IA
  • NPI 1366156820
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1689635518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 UTICA RIDGE ROAD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-359-9165",
            "fax_number": "563-359-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 UTICA RIDGE ROAD",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-359-9165",
            "fax_number": "563-359-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "7854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144162",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Campion Chiropractic PC
• Campion Chiropractic PC
• Damian John Campion, DC
• Karin Sue Campion, DC
• Christopher Mark Cannon, DDS PC
• James Patrick Canny, CRNA
• Caprock Inc
• Caras Chiropractic and Performance Care
• Nicholas Dan Caras, D.C.
• Randel O Cardott, M.D.

• Dentist in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.